Provider Demographics
NPI:1699857250
Name:WEBB, STEPHEN KENT (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:KENT
Last Name:WEBB
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:601 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:TX
Mailing Address - Zip Code:79072-6219
Mailing Address - Country:US
Mailing Address - Phone:806-293-1376
Mailing Address - Fax:806-291-8700
Practice Address - Street 1:601 W 7TH ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:TX
Practice Address - Zip Code:79072-6219
Practice Address - Country:US
Practice Address - Phone:806-293-1376
Practice Address - Fax:806-291-8700
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2013-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX6267TG152W00000X, 152WC0802X, 152WL0500X, 152WS0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
No152WS0006XEye and Vision Services ProvidersOptometristSports Vision
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXU90944Medicare UPIN
TX6331980001Medicare NSC
613994Medicare PIN